scholarly journals A prevalence study into use and management of peripheral intravenous catheters

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Azlina Daud ◽  
Hazimah Rahman ◽  
Farrah Ilyani Che Jamaluddin
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Medication Administration ◽  
General Ward ◽  
Prevalence Study ◽  
Intravascular Catheter ◽  
Chi Square ◽  
Total Admission ◽  
Chi Square Test ◽  
Intravenous Catheters

Introduction: There are over half of patients admitted to the hospital required peripheral intravascular catheter (PIVC) inserted. However, there are no data reported on the use of PIVC in Malaysia. Thus, this study aims to determine the prevalence of PIVCs use and PIVC complications in patients with PIVC. Methods: An observational study was conducted on patients who had PIVC in medical, surgical, obstetric and orthopedic wards in Hospital Tunku Ampuan Afzan, Kuantan, Malaysia. Results: Over 2 months, the total admission for 4 wards was 1466 and out of this total admission, 490 patients were recruited. Reasons for PIVC insertion were for IV fluids (62.4%) and for medication administration (31.8%). Most of the PIVC inserted in the general ward (91.8%) followed by from an emergency department. The PIVC insertion was done by the doctor (84.5%). All patients used the same brand of catheter, which is Vasofix Branulle and used transparent polyurethane dressing. There were 28 (5.7%) patients have signs of thrombophlebitis. The Chi-square test showed that there was a significant association between day of PIVC insertion with thrombophlebitis (p = 0.006). Conclusions: In conclusion, the study processes resulted in a proportion of 33.4% of patients with PIVC with the total number of admission to the 4 wards and 5.7% patients have signs of thrombophlebitis.

Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
ghufran adnan ◽  
Osman Faheem ◽  
Maria Khan ◽  
Pirbhat Shams ◽  
Jamshed Ali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Reduction Rate ◽  
Care Hospital ◽  
Chi Square ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Drastic Increase ◽  
Chi Square Test ◽  
The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

scholarly journals Patient safety in nursing care during medication administration

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Júlian Katrin Albuquerque de Oliveira ◽  
Eliana Ofélia Llapa-Rodriguez ◽  
Iza Maria Fraga Lobo ◽  
Luciana de Santana Lôbo Silva ◽  
Simone de Godoy ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Medication Administration ◽  
Test Results ◽  
Chi Square ◽  
Exact Test ◽  
Direct Observations ◽  
Nursing Team ◽  
Chi Square Test ◽  
Vascular Catheters ◽  
Multidose Vial

ABSTRACT Objective: to evaluate the conformity of care practices of the nursing team during the administration of drugs through central vascular catheter. Method: a descriptive, prospective, observational study conducted in an Intensive Care Unit. The non-probabilistic intentional sample consisted of 3402 observations of drug administrations in patients with central vascular catheters. The previously validated collection instrument was constructed based on the Guideline for Prevention of Intravascular catheter-related infections. Data was collected through direct observations of nursing practices performed by the nursing team. The analysis used analytical, descriptive and inferential statistics (Chi-square test and Fisher’s exact test). Results: a total of 3402 procedures of drug administrations were observed. Female nursing technicians performed the highest number of actions. In none of the procedures did the professional perform all necessary actions. 0.2% of drug administrations were preceded by hand hygiene and 1.3% by disinfection of the multidose vial, ampoule or injectors. Conclusion: the practice evaluated was classified as undesirable. Failure to achieve the desired conformity was probably due to the low adherence of professionals to the practice of hand hygiene and disinfection of materials, injectors and connectors.

scholarly journals Agreement between Impression of Stroke in the Emergency Department and Diagnosis at the Neurology Department

2019 ◽  
Vol 7 (3) ◽  
pp. 7
Author(s):  
Samad Shams-Vahdati ◽  
Alireza Ala ◽  
Eliar Sadeghi-Hokmabad ◽  
Neda Parnianfard ◽  
Maedeh Gheybi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Ischemic Stroke ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Chi Square ◽  
Prevention Therapy ◽  
Significant Difference ◽  
Chi Square Test ◽  
Academic Teaching Hospital ◽  
The Mean

Background: Missing to detect an ischemic stroke in the emergency department leads to miss acute interventions and treatment with secondary prevention therapy. Our study examined the diagnosis of stroke in the emergency department (ED) and neurology department of an academic teaching hospital. Methods and Materials: A retrospective chart review was performed from March 2017 to March 2018. ED medical document (chart) were reviewed by a stroke neurologist to collect the clinical diagnosis and characteristics of ischemic stroke patients. For determining the cases of misdiagnosed and over diagnosed data, the administrative data codes were compared with the chart adjudicated diagnosis. The adjusted estimate of effect was estimated through testing the significant variables in a multivariable model. The comparisons were done with chi square test. Statistical significance was considered at P < 0.05. Results: Of 861 patients of the study, 54% were males and 43% were females; and the mean age of them was 66.51 ± 15.70. We find no statically significant difference between patient’s Glasgow Coma Scale (GCS) in the emergency department (12.87±3.25) and patients GCS in the neurology department (11.77±5.15). There were 18 (2.2%) overdiagnosed of ischemic stroke, 8 (0.9%) misdiagnosed of ischemic stroke and 36 (4.1%) misdiagnosed of hemorrhagic strokes in the emergency department. Conclusion: There was no significant difference between impression of stroke in the emergency department and diagnosis at the neurology department.

Lung cancer: Significance of place of diagnosis.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 60-60
Author(s):  
Rohit Bishnoi ◽  
Chintan Shah ◽  
Jacobo Hincapie Echeverri ◽  
Katherine Robinson ◽  
Yu Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Emergency Department ◽  
Cox Regression ◽  
Health Care Cost ◽  
Small Cell ◽  
Cost Of Care ◽  
Chi Square ◽  
Kaplan Meier ◽  
Therapy Cost ◽  
Chi Square Test

60 Background: Patients who are diagnosed with lung cancer through emergency department tend to do poorly. We conducted a retrospective study to examine the effect of place of diagnosis on various cancer outcomes including survival, health care cost, and end-of-life (EOL) care. Methods: Patients who died from lung cancer between January 2015 and July 2017 were reviewed. Initial place of diagnosis was determined (Emergency Department/Urgent clinic (ED/UC) or Outpatient). Descriptive statistics, exact Pearson chi-square test, Kaplan-Meier method, and multivariable Cox regression model were used to compare the two groups. Results: 227 patients were included in the analysis. Median age at diagnosis was 65 years. 52% were male; 85% were white. 57% of patients were diagnosed through ED/UC, whereas 43% were diagnosed as part of an outpatient workup. Age, gender, race, and histology (small cell vs. non-small cell) did not vary significantly between the two groups. Rates of palliative care intervention and advance directives were similar. Patients diagnosed through ED/UC were more likely to be metastatic, have symptoms, and not receive any cancer directed therapy. Cost of care was similar between the two groups. Median survival in those who presented to ED/UC was significantly shorter (2.5 vs. 6.5 mo; p<0.001) with a hazard ratio of 1.7 (95% CI:1.3-2.3), even after adjusting for potential confounding factors (age, metastasis, insurance, smoking, treatment). Conclusions: Patients diagnosed with lung cancer through the ED/UC have worse outcomes than those diagnosed as an outpatient. Despite similar cost of care, survival outcomes are worse. This variable remains significant despite controlling for confounders in multivariate analysis.[Table: see text]

scholarly journals Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
William Massavon ◽  
Levi Mugenyi ◽  
Martin Nsubuga ◽  
Rebecca Lundin ◽  
Martina Penazzato ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Systems Strengthening ◽  
People Living With Hiv ◽  
Chi Square ◽  
Loss To Follow Up ◽  
Resource Limited ◽  
Home Based ◽  
Chi Square Test ◽  
Adults And Children ◽  
Home Based Care

Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes.

scholarly journals 998. Missclassification of Community and Hospital Onset Bloodstream Infections Using Laboratory-Identified Events

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S297-S297
Author(s):  
Riad Khatib ◽  
Mamta Sharma ◽  
Mohamad G Fakih ◽  
Kathleen Riederer ◽  
Leonard Johnson
Keyword(s):  
Infective Endocarditis ◽  
Hospital Setting ◽  
Bloodstream Infections ◽  
Candida Spp ◽  
Chi Square ◽  
Gram Negative ◽  
Chi Square Test ◽  
Polymicrobial Bacteremia ◽  
Intravenous Catheters ◽  
Community Onset

Abstract Background Laboratory-identified bloodstream infections (LAB-ID-BSI) are classified as community onset (CO) if blood culture (BC) is collected within 3 days after facility admission and hospital onset if ≥4 days. This classification is often based on a computer-generated subtraction of the day of admission from day of onset. This method may miss recent prior hospitalizations at the same or different facilities. Methods We reviewed BC results (January 1, 2010–December 31, 2016), selected patients with BSI and defined the place of onset as CO (day 0–3) and HO (≥4 days) of admission based on LABID-BSI. All patients with CO were further evaluated to determine whether they were recently hospitalized. The source and microbiology of patients with hospitalization within 14 days of the onset of BSI was compared with HO and CO without prior admission within 6 months. Results We encountered 5,179 BSI episodes, 3866 (74.6%) were CO. Prior hospitalization in any hospital within 1–14 and 15–180 days of onset was documented in 659 (17.0%) and 1,465 (37.9%), respectively. Source of bacteremia and type of organisms in patients with prior hospitalization within 1–14 days were closer to HO than patients without prior hospitalization with higher frequency of Intravenous catheters (IVC), polymicrobial bacteremia, and candidemia (table). Conclusion Using Lab-ID events to classify BSI, one in six patients may risk being misclassified as CO. This underestimates BSI related to hospital setting. Onset classification should be based on thorough historical information and not a computer-generated subtraction of admission and Lab event dates. Infective endocarditis; soft tissue/bone; pneumonia; abdomen; unknown/miscellaneous; polymicrobial. Gram-positive; Gram-negative; anaerobes; Candida spp. a: P &lt; 0.01; chi square test. Disclosures All authors: No reported disclosures.

scholarly journals The correlation between response time and waiting time on patients’ satisfaction at the emergency departement

2020 ◽  
Vol 1 ◽  
pp. 142-145
Author(s):  
Wasis Sapto Putro ◽  
Sodikin Sodikin
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Response Time ◽  
Waiting Time ◽  
Quantitative Research ◽  
Sampling Technique ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
The Right

Fast and accurate services are essential in the Emergency Departement (ED). Services in the emergency room will be hampered if it is are full of patients. If this is not managed well, the right services cannot be implemented. In turn, it will have a bad effect on patient satisfaction. To analyze the correlation between response time and waiting time with patient satisfaction during service at the Emergency Department of the Banyumas Regional General Hospital.This research is quantitative research. The sampling technique in this study used purposive sampling of 96 respondents. The statistical test used is the chi square test.Most respondents percieved the responding time in ER is fast; most of them also rated that the waiting time in ER is short. Most of them are also satisfied with ER services. The chi square test results in p value of <0.05 for each variable. It means there is a relationship between response time and waiting time with patient satisfaction during service at the Emergency Department of Banyumas Regional General Hospital.Response time and waiting time are related to patient satisfaction during service at the Emergency Department of Banyumas Regional General Hospital.

scholarly journals PENGETAHUAN PETERNAK TENTANG ESTRUS PADA SAPI ACEH DENGAN TERJADINYA REPEAT BREEDING DI KABUPATEN PIDIE

2020 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Djoko Subagyo, Tongku N Siregar, Teuku Reza Ferasyi Dasrul, Mustafa Sabri
Keyword(s):  
Observational Study ◽  
Direct Observation ◽  
Odds Ratio ◽  
Secondary Data ◽  
Animal Husbandry ◽  
Primary Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Level Of Knowledge

The study was aimed to determine the level of knowledge of farmers about cattle estrus Aceh with the occurrence of repeat breeding in Pidie District. Samples were obtained from secondary data reports for   animal husbandry Department  aceh Pidie 161 female cows study was. Carried out in the form of observational study with cross sectional approach. Primary data were collected by direct observation and interviews with questionnaires to farmers and inseminator. The data were analyzed descriptively. Chi Square test (X2) was used to determine the association between factors that cause, while Odds Ratio (OR) was used to calculate the strength of the association. The results of this study which has gained significantly associated (P less-than 0.05) on the incidence of repeat breeding is knowledge estrus  with  OR = 2.3. And the conclusion is. knowledge estrus against Aceh cattle repeat breeding associated with the occurrence of repeat positive or are associated.  Keywords:  knowledge estrus, repeat breeding, cattle Aceh

Trends and repetition of non-fatal suicidal behaviour: analyses of the Gold Coast University Hospital’s Emergency Department

2018 ◽  
Vol 26 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Kairi Kõlves ◽  
David Crompton ◽  
Kathryn Turner ◽  
Nicolas JC Stapelberg ◽  
Ashar Khan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Suicidal Behaviour ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Age Groups ◽  
Cox Proportional Hazards ◽  
Gold Coast ◽  
First Year ◽  
Chi Square ◽  
Chi Square Test

Objective The aim of the current paper is to analyse time trends of non-fatal suicidal behaviour (NFSB) and its repetition at the Gold Coast in 2005–2015. Methods Data on presentations for NFSB were obtained from the Emergency Department (ED) Information System. Potential cases were identified through keyword searches, which were further scrutinised and coded. Annual person-based age-standardised rates for NFSB were calculated. Chi-square test, Poisson regression and Cox proportional hazards regression were used. Results: There was a significant increase in the age-standardised rates of NFSB for males (incidence Rate Ratio = 1.05; 95% confidence interval (CI): 1.04–1.07) and females (iRR = 1.06; 95% CI: 1.04–1.07). Age-specific rates showed significant increases for all age groups, except 25–34 and 55+ for females. Different types of poisoning were the predominant method of NFSB (poisoning only – 61.7% of episodes), followed by cutting (23%). Within the first year after the index episode, 13.4% of subjects repeated NFSB. Multivariate Cox regression model showed that sex, age and method predicted repetition. Conclusion: The increasing trends of NFSB and relatively high repetition rates emphasise the need for preventative actions. Monitoring of NFSB at the ED level should be further extended in Australia.

scholarly journals Assessment of patient safety challenges and electronic occurrence variance reporting (e-OVR) barriers facing physicians and nurses in the emergency department: a cross sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ahmed I. Albarrak ◽  
Ammar S. Almansour ◽  
Ali A. Alzahrani ◽  
Abdulaziz H. Almalki ◽  
Abdulrahman A. Alshehri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Electronic Reporting ◽  
Chi Square Test ◽  
Usability Data

Abstract Background The purpose of patient safety is to prevent harm occurring in the healthcare system. Patient safety is improved by the use of a reporting system in which healthcare workers can document and learn from incidents, and thus prevent potential medical errors. The present study aimed to determine patient safety challenges facing clinicians (physicians and nurses) in emergency medicine and to assess barriers to using e-OVR (electronic occurrence variance reporting). Methods This cross-sectional study involved physicians and nurses in the emergency department (ED) at King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. Using convenience sampling, a self-administered questionnaire was distributed to 294 clinicians working in the ED. The questionnaire consisted of items pertaining to patient safety and e-OVR usability. Data were analyzed using frequencies, means, and percentages, and the chi-square test was used for comparison. Results A total of 197 participants completed the questionnaire (67% response rate) of which 48 were physicians (24%) and 149 nurses (76%). Only 39% of participants thought that there was enough staff to handle work in the ED. Roughly half (48%) of participants spoke up when something negatively affected patient safety, and 61% admitted that they sometimes missed important patient care information during shift changes. Two-thirds (66%) of the participants reported experiencing violence. Regarding e-OVR, 31% of participants found reporting to be time consuming. Most (85%) participants agreed that e-OVR training regarding knowledge and skills was sufficient. Physicians reported lower knowledge levels regarding how to access (46%) and how to use (44%) e-OVR compared to nurses (98 and 95%, respectively; p < 0.01). Less than a quarter of the staff did not receive timely feedback after reporting. Regarding overall satisfaction with e-OVR, only 25% of physicians were generally satisfied compared to nearly half (52%) of nurses. Conclusion Although patient safety is well emphasized in clinical practice, especially in the ED, many factors hinder patient safety. More awareness is needed to eliminate violence and to emphasize the needs of additional staff in the ED. Electronic reporting and documentation of incidents should be well supported by continuous staff training, help, and feedback.

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